Glycopeptide compositions

ABSTRACT

Solutions comprising a glycopeptide antibiotic, for example Vancomycin, and an amino acid or amino acid derivative such as N-acetyl-Glycine or N-acetyl-D-Alanine are provided. These solutions are stable or stabilized for long-term periods at conditions of normal use and storage, and can be formulated as pharmaceutical solutions for use in subjects. Methods of manufacturing and using these solutions are also provided, as are methods of stabilizing a glycopeptide antibiotic, for example Vancomycin, using amino acids or amino acid derivatives such as N-acetyl-Glycine or N-acetyl-D-Alanine.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.15/524,653, filed on May 5, 2017, which is a National Stage applicationof PCT/EP2015/075918, filed on Nov. 6, 2015, which claims the benefit ofU.S. Provisional Applications 62/076,400, filed on Nov. 6, 2014 and62/168,749, filed on May 30, 2015 all of which are incorporated byreference in their entirety herein.

BACKGROUND

Vancomycin is a tricyclic glycopeptide antibiotic derived fromAmycolatopsis orientalis (formerly Nocardia orientalis).

In pharmaceutical use, it is usually administered as the hydrochloridesalt, Vancomycin hydrochloride. This salt has previously been suppliedfor oral and parenteral use as a dry solid or as a frozen liquidpreparation. Heretofore, liquid formulations of Vancomycin hydrochloridehave been impractical as pharmaceutical preparations because of thelimited stability of the Vancomycin hydrochloride in the aqueoussolution suitable for parenteral use. Similar limitations have beenobserved for liquid solutions made from glycopeptide antibiotics relatedto Vancomycin.

Vancomycin hydrochloride is indicated for the treatment of serious orsevere infections caused by susceptible strains of methicillin-resistant(beta-lactam-resistant) staphylococci. It is indicated forpenicillin-allergic patients, for patients who cannot receive or whohave failed to respond to other drugs, including the penicillins orcephalosporins, and for infections caused by vancomycin-susceptibleorganisms that are resistant to other antimicrobial drugs. Relatedglycopeptide antibiotics, such as Teicoplanin and Telavancin, are alsoused for the treatment of multi-drug resistant gram-positive bacterialinfections.

Many attempts have been performed to stabilize Vancomycin and relatedglycopeptide antibiotics in liquid preparations.

U.S. Pat. No. 4,670,258 disclosed protection of Vancomycin againstthermal degradation by mixing certain acetylated dipeptides ortripeptides with Vancomycin in solution in a narrow molar ratio of 1 to2 moles of peptide to Vancomycin. The use of similarly derivatizedsingle amino acids was not suggested or investigated. The acetylatedpeptides studied in this patent are designed to mimic the binding ofVancomycin to its target in vivo, and the inventors believed that thisprevented inactivation of Vancomycin by blocking formation of anisoaspartate from the Vancomycin backbone asparagine residue. However,stability of the Vancomycin in solution was only measured up to 66 hoursat room temperature and at 80 degrees Celsius.

WO9719690 disclosed stable solutions of Vancomycin HCl comprising0.5-30% vol/vol ethanol. These solutions are claimed to be particularlyuseful for storage in a liquid state not requiring either freezing orfreeze-drying in order to maintain stability.

JP11080021 mentioned Vancomycin injection solutions showing storagestability comprising water, Vancomycin and 0.1-10 wt % amino acids (i.e.Glycine) to inhibit color formation.

U.S. Pat. No. 8,778,873 discloses a stability study for a combination ofCeftriazone and Vancomycin at pH 8.8. L-arginine, L-Lysine andL-Histidine are claimed as “compatibility/stabilizing agent”.

WO2014026052 disclosed that a D-AA mixture enhanced the effect ofRifampin, Clindamycin, and Vancomycin resulting in significantreductions of bacterial CFUs within the biofilms.

US20140260098A1 mentioned that stabilizers and/or solubilizers are addedto the Vancomycin hydrochloride solution to get a mixture solution ofVancomycin hydrochloride and excipients. The stabilizers may comprisesaccharides and/or polyols. The formulation with trehalose and tween hasthe best product stability.

WO2014085526 discloses stabilized lipid-based Vancomycin compositionswherein amino acids or derivatives thereof stabilize Vancomycin.

Several groups have studied the interactions of Vancomycin and relatedglycopeptide antibiotics with certain ligands in order to betterunderstand the interactions of the antibiotic molecules targets in vivo.

For example, McPhail and Cooper, J. Chem. Soc, Faraday Trans., vol 93.no 13, 1997, compared the thermodynamics of dissociation of Vancomycinand Ristocetin dimers in the presence and absence of weakly binding(acetate, N-acetyl-D-Ala) and strongly binding(Nα,Nε-diacetyl-Lys-D-Ala-D-Ala) ligands over a range of conditions.

Loll et al, Chemistry and Biology, vol. 5 no. 5, 1998 disclosed thecrystal structure of Vancomycin in complex with N-acetyl-D-Alanine(AcDA), which demonstrates that Vancomycin forms ligand-mediatedface-to-face dimers as well as the ligand-independent back-to-backdimers previously observed by nuclear magnetic resonance.

Loll et al, Journal of Medicinal Chemistry, 1999, Vol. 42, No. 22 4715,1999 showed how N-acetyl-D-Alanine and N-acetyl-Glycine binds toVancomycin.

Still other groups have studied the interaction of peptide and singleamino acid ligands to Vancomycin in terms of molecular rigidity andconformation changes induced in Vancomycin by such binding interactions.These groups showed that peptide ligands interact with the molecularbackbone of Vancomycin and related glycopeptide antibiotics in multipleplaces, while single amino acid ligands such as N-acetyl-D-Alanineinteract in a more limited fashion. See, e.g., Brown J P et al. (1975),Mol. Pharmacol. 11:126-132; Harris C M et al. (1984), J. Antibiotics38(1): 51-57; Williams D H et al. (1993), Proc. Nat. Acad. Sci. US90:1172-1178; Pearce C M et al. (1995), J. Chem. Sci. Perkins Trans. 2:159-162; and Rao J et al. (1999), Chem. & Biol. 6: 353-359. Harris C Met al. suggest that the relative structural rigidity conveyed to theVancomycin molecule on binding with di- and tri-peptides in solutionblocked rearrangement of the Vancomycin backbone asparagine toisoaspartate via a cyclic imide intermediate. This is consistent withthe observation of the inventors in U.S. Pat. No. 4,670,258 discussedabove. However, although single amino acid ligands such asN-acetyl-D-Alanine may be involved in glycopeptide antibioticdimerization in solution under certain conditions, it is not clear thatsuch ligands confer similar structural rigidity in a complex withantibiotics such as Vancomycin as do the di- and tri-peptide ligands.Moreover, these studies did not investigate or discuss the long-termstability of Vancomycin and related glycopeptide antibiotics insolutions for pharmaceutical use.

Raverdy et al (J Antimicrob Chemother 2013; 68: 1179-1182), observed thestability of an intravenous solution of 10 g/L Vancomycin in 5% glucosefor up to 48 hours under conditions that simulated delivery of thesolution to a patient, and for up to 72 hours at 50 degrees Celsius. Thestudy also examined the solution's compatibility with various substancesco-administered through a Y-connector, for a contact time of one hour atroom temperature. The authors concluded that, under the observedconditions and times, the Vancomycin was stable and thatN-acetyl-Cysteine (used as an antioxidant in cases of Paracetamolintoxication) and amino acid solutions (used for parenteral nutrition)did not cause alteration of Vancomycin when co-administered. However,the conditions and components necessary for long-term stability ofVancomycin solutions were not investigated or discussed.

Thus, there remains a need for solutions of Vancomycin and relatedglycopeptides which possess long-term stability under conditions ofnormal use and storage, and which remain suitable for administration toa subject throughout their stability period.

SUMMARY OF THE INVENTION

The present invention concerns stabilized pharmaceutical compositionscomprising glycopeptide antibiotics. In preferred embodiments, presentinvention concerns stabilized pharmaceutical compositions comprisingVancomycin.

The present invention provides glycopeptide antibiotic compositionscomprising an N-acetyl-D-amino acid or N-acetyl-Glycine.

The present invention provides glycopeptide antibiotic compositionscomprising an N-acetyl-D-amino acid or N-acetyl-Glycine for use as amedicament.

The present invention provides glycopeptide antibiotic compositionscomprising an N-acetyl-D-amino acid or N-acetyl-Glycine for use intreatment of bacterial infections.

The present invention provides glycopeptide antibiotic compositionscomprising N-acetyl-D-Alanine or N-acetyl-Glycine.

The present invention provides glycopeptide antibiotic compositionscomprising N-acetyl-D-Alanine or N-acetyl-Glycine for use as amedicament.

The present invention provides glycopeptide antibiotic compositionscomprising N-acetyl-D-Alanine or N-acetyl-Glycine for use in treatmentof bacterial infections.

In one embodiment of the present invention, the compositions areaqueous.

In one embodiment of the present invention, the compositions are aqueousand have a pH of about 2-7.

In one embodiment of the present invention, the compositions are aqueousand have a pH of about 3-6.

In one embodiment of the present invention, the compositions are aqueousand have a pH of about 4.0-5.5.

In one embodiment of the present invention, the compositions are aqueousand have a pH of about 4.5-5.5.

In one embodiment of the present invention, the compositions furthercomprise an amino acid and/or an organic solvent.

In one embodiment of the present invention, the compositions furthercomprise an amino acid selected from Glycine, Alanine, Serine, Leucine,Valine, Lysine, Arginine and Ornithine.

In one embodiment of the present invention, the compositions furthercomprise an amino acid selected from D-Alanine, D-Serine, D-Leucine,D-Valine, L-Lysine, D-Lysine, L-Ornithine, D-Ornithine or L-Arginine.

In one embodiment of the present invention, the compositions furthercomprise an amino acid selected from D-Serine, D-Leucine, D-Valine,L-Lysine, D-Lysine, L-Ornithine, D-Ornithine or L-Arginine.

The compositions according to the present invention are suitable forstorage in liquid state, thus providing vials, syringes and “ready touse” IV containers, as are known in the art, comprising the stabilizedVancomycin compositions. When administering these to patients, there isno need for the step of reconstituting a lyophilized Vancomycin powder;however, the content of vials and syringes could be further diluted totarget concentration prior to administration. Suitable diluents forsolutions of the invention include any known diluent acceptable forpharmaceutical use (e.g., intravenous administration); for example,water, physiological saline, 5% dextrose solution, lactated Ringer'ssolution or combinations thereof.

The present invention further provides a method for stabilizingglycopeptide antibiotics which involves addition of N-acetyl-D-aminoacids to a solution comprising a glycopeptide antibiotic or addition ofa glycopeptide antibiotic to a solution comprising N-acetyl-D-aminoacids.

In one embodiment, at least one additional amino acid is also addedand/or at least one pharmaceutically acceptable organic solvent isadded.

The present invention provides a method for stabilizing a glycopeptideantibiotic which involves addition of N-acetyl-D-Alanine to a solutioncomprising a glycopeptide antibiotic or addition of a glycopeptideantibiotic to a solution comprising N-acetyl-D-Alanine.

In one embodiment, at least one additional amino acid is also addedand/or at least one pharmaceutically acceptable organic solvent isadded.

The present invention provides solutions comprising about 0.1-1% w/V ofVancomycin and N-acetyl-D-Alanine, wherein the solutions have a pH ofabout 4-6.

In one embodiment, the solutions further comprise an amino acid selectedfrom D-Alanine, D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine,L-Ornithine, D-Ornithine or L-Arginine.

In another embodiment, the solutions further comprise L-Lysine.

In another embodiment, the solutions further comprise L-Lysine and havea pH of about 4.5-5.5.

In another embodiment, the solutions further comprise L-Lysine and havea pH of about 4.5-5.5, wherein the molar ratio of glycopeptideantibiotic to L-Lysine is about 1:5-1:30.

In another embodiment, the solutions further comprise L-Lysine and havea pH of about 4.5-5.5, wherein the molar ratio of glycopeptideantibiotic to N-acetyl-D-Alanine is about 1:5-1:40 and wherein the molarratio of glycopeptide antibiotic to L-Lysine is about 1:5-1:30.

The present invention provides solutions comprising about 3-10% w/Vglycopeptide antibiotic and N-acetyl-D-Alanine, wherein the solutionshave a pH of about 4-6.

The present invention provides solutions comprising about 0.1-1% w/Vglycopeptide antibiotic and N-acetyl-D-Alanine, wherein the solutionshave a pH of about 4-6.

The present invention provides solutions comprising about 1-10% w/Vglycopeptide antibiotic and N-acetyl-D-Alanine, wherein the solutionshave a pH of about 4-6.

In one embodiment, the solutions further comprise an amino acid selectedfrom D-Alanine, D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine,L-Ornithine, D-Ornithine or L-Arginine.

In another embodiment, the solutions further comprise L-Lysine.

In another embodiment, the solutions further comprise L-Lysine and havea pH of about 4.5-5.5.

In another embodiment, the solutions further comprise L-Lysine and havea pH of about 4.5-5.5, wherein the molar ratio of glycopeptideantibiotic to L-Lysine is about 1:0.5-1:4.

In another embodiment, the solutions further comprise L-Lysine and havea pH of about 4.5-5.5, wherein the molar ratio of glycopeptideantibiotic to N-acetyl-D-Alanine is about 1:1-1:4 and wherein the molarratio of glycopeptide antibiotic to L-Lysine is about 1:0.5-1:4.

The present invention provides aqueous solutions comprising about 0.5%w/V of glycopeptide antibiotic and L-Lysine and N-acetyl-D-Alanine in amolar ratio of about 1:20:30, wherein the solutions have a pH of about4.5-5.5.

The present invention provides aqueous solutions comprising about 5% w/Vof glycopeptide antibiotic and L-Lysine and N-acetyl-D-Alanine in amolar ratio of about 1:2:2, wherein the solutions have a pH of about4.5-5.5.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a representation of the molecular structures of Vancomycin,Teicoplanin, Telavancin, Dalbavancin and Oritavancin as disclosed byKang and Park, Journal of Bacteriology and Virology 2015 vol. 45 no. 2pages 67-78.

DETAILED DESCRIPTION

Vancomycin is a tricyclic glycopeptide antibiotic. Its structure isrepresented in Formula 1. Its purity in the formulation can be assessedby the content of Vancomycin B.

“Vancomycin” as used herein means the compound represented in Formula 1and also pharmaceutically acceptable salts thereof, for exampleVancomycin Hydrochloride.

Aqueous compositions comprising “Vancomycin HCl” is meant to cover, butnot meant to be limited to, solutions made by dissolving Vancomycin HClor by addition of equimolar amounts of HCl to Vancomycin base.

Vancomycin degrades into the following main degradation impurities: DAMS(Des-(amido)-succinimido-Vancomycin B), which then converts toDes-(amido)-isoaspartate-Vancomycin B minor/major (CDP1-m/M). Theimpurities Des-(amido)-isoaspartate-Vancomycin B minor/major arequantified as one impurity named CDP1.

Structures of these two impurities are shown below as Formulas 2, 3a and3b.

Other glycopeptide antibiotics which are related to Vancomycin are alsowithin the scope of the invention. As used herein, “glycopeptideantibiotic” means molecules which contain a heptapeptide structureproviding specific affinity for the D-alanyl-D-Alanine terminus of thepeptidoglycan pentapeptide including, for example, Vancomycin,Telavancin, Oritavancin, Teicoplanin and Dalbavancin (See Parenti &Cavalleri, Journal of Antibiotics, December 1989 page 1882). Structuresfor some of these molecules are shown in FIG. 1, which is adapted fromKang and Park, Journal of Bacteriology and Virology, 2015 vol. 45 no. 2pages 67-78.

A “composition” is any mixture comprising more than one compound, forexample a mixture of two active ingredients or a mixture of an activepharmaceutical ingredient and one or more pharmaceutical excipients. The“compositions” according to the present invention include, but are notlimited to, bulk solutions, solutions made by dissolving a lyophilizedpowder and pharmaceutical solutions.

A “pharmaceutical composition” is any composition suitable and intendedfor in vivo use, for example administration to a patient or a subject.As used herein, the terms “patient” and “subject” are interchangeable,and refer to any human or animal individual who is receiving acomposition of the invention.

An “aqueous pharmaceutical composition” is a solution suitable andintended for in vivo use, for example administration to a patient,either directly or after dilution with a suitable diluent.

The term “amino acid” means any amino acid, including, but not limitedto the 20 amino acids naturally occurring in peptides in both D andL-form and is also meant to cover any salt thereof, especiallypharmaceutically acceptable salts. For example, the term “amino acid”includes Alanine, Arginine, Asparagine, Aspartic acid, Cysteine,Glutamic acid, Glutamine, Glycine, Histidine, Isoleucine, Leucine,Lysine, Methionine, Phenylalanine, Proline, Serine, Threonine,Tryptophan, Tyrosine, Valine and Ornithine, and any conformationsthereof.

Thus the term “amino acid” includes L-Alanine, L-Arginine, L-Asparagine,L-Aspartic acid, L-Cysteine, L-Glutamic acid, L-Glutamine, L-Histidine,L-Isoleucine, L-Leucine, L-Lysine, L-Methionine, L-Phenylalanine,L-Proline, L-Serine, L-Threonine, L-Tryptophan, L-Tyrosine, L-Valine andL-Ornithine.

Thus included is D-Alanine, D-Arginine, D-Asparagine, D-Aspartic acid,D-Cysteine, D-Glutamic acid, D-Glutamine, D-Histidine, D-Isoleucine,D-Leucine, D-Lysine, D-Methionine, D-Phenylalanine, D-Proline, D-Serine,D-Threonine, D-Tryptophan, D-Tyrosine, D-Valine and D-Ornithine.

“N-acetyl-Glycine” is a compound represented by the following structure:

or the compound as indicated by the CAS registry number 543-24-8. It canexist as an acid or in deprotonated form. The term “N-acetyl-Glycine” isalso meant to cover any salt thereof, especially pharmaceuticallyacceptable salts.

“N-acetyl-D-Alanine” is a compound which could be represented by thefollowing structure:

or the compound as indicated by the CAS registry number: 19436-52-3. Itcan exist as an acid or in deprotonated form. The term“N-acetyl-D-Alanine” is also meant to cover any salt thereof, especiallypharmaceutically acceptable salts.

“N-acetyl-D-amino acids” are compounds represented by the followingstructure

wherein R1 is a side chain of α-amino acids. Examples of such sidechains include —CH₃, —CH₂OH and —CH(CH₃)₂ which are the side chains ofAlanine, Serine and Valine, respectively. The term “N-acetyl-D-aminoacids” is also meant to cover any salt thereof, especiallypharmaceutically acceptable salts.

“N-modified-D-amino acids” are compounds represented by the followingstructure

in which R1 is selected from —CH₃, —CH₂OH, —CH(CH₃)₂, and R2 is selectedfrom —H, —CH₃, —CH₂CH₃. The term “N-modified-D-amino acids” is meant tocover salts (including pharmaceutically-acceptable salts) thereof.

“pH” is the conventional measurement unit of hydrogen ion activity in asolution at 25° C. unless another temperature is specified.

“pH of 3-6” is meant to include any pH value from 3-6 including pH 3 andincluding pH 6 and any pH value in between 3 and 6.

“pH of 4-5.5” is meant to include any pH value from 4-5.5 including pH 4and including pH 5.5 and any pH value in between 4 and 5.5.

The pH of the Vancomycin compositions according to the present inventionis affected by the concentration of each of the ingredients. The pH ofthe Vancomycin solutions according to the present invention can beadjusted in any suitable manner, e.g. by addition of aqueoushydrochloric acid solutions or aqueous sodium hydroxide solutions. Suchsolutions can be diluted or concentrated. Thus, suitable pH adjustingagents include, but are not limited to 0.01 M HCl, 0.1 M HCl, 1 M HCl, 2M HCl, 3 M HCl, 4 M HCl, 5 M HCl, 6 M HCl, 0.01 M NaOH, 0.1 M NaOH, 1 MNaOH, 2 M NaOH, 3 M NaOH, 4 M NaOH, 5 M NaOH and 6 M NaOH. Thus,suitable pH adjusting agents include, but are not limited to 0.01-6 MHCl and 0.01-6 M NaOH.

“Ultrapure water” means substantially pure water, e.g. water purified bydistillation or a purification process that is equivalent or superior todistillation in the removal of chemicals.

“Aqueous composition” means any solution in which water is the mainsolvent (equal or above 50% V/V). Aqueous solutions include, but are notlimited to solutions comprising about 50%, 60%, 70%, 80%, 85%, 90%, 95%,98% or 99% V/V water. The aqueous solutions can comprise apharmaceutically acceptable organic solvent like ethanol, polyethyleneglycols (PEG 200, PEG 300, PEG 400, PEG 600, PEG 4000 etc.). The aqueoussolutions can comprise about 50% V/V or less of a pharmaceuticallyacceptable organic solvent like ethanol, PEG 300, PEG 400 etc.

“Bulk solution” is any solution suitable for lyophilization or forfilling into vials, syringes or infusion containers (e.g., bottles or IVbags).

Glycopeptide antibiotic compositions according to the present inventioncan thus be in a liquid state; e.g., aqueous solutions with water as theonly solvent or aqueous solutions further comprising an organic solvent(e.g., addition of about 2-50% V/V organic solvent, addition of about2-40% V/V organic solvent, about 5-40% V/V of organic solvent, about10-30% V/V of organic solvent etc.).

Suitable organic solvents for the stabilized glycopeptide antibioticcompositions according to the present invention include anypharmaceutically acceptable solvent able to increase the solubility ofthe amino acids in the glycopeptide antibiotic solution. They include,but are not limited to, ethanol and polyethylene glycols (PEG 200, PEG300, PEG 400, PEG 600, PEG 4000 etc.)

According to a preferred embodiment of the present invention, theglycopeptide antibiotic solutions comprise about 5-30% V/V of ethanol.According to another preferred embodiment of the present invention,glycopeptide antibiotic solutions comprise about 10% V/V of ethanol.

According to another preferred embodiment of the present invention, theglycopeptide antibiotic solutions comprise about 50-60% V/V ofpolyethylene glycol. According to a preferred embodiment of the presentinvention, the glycopeptide antibiotic solutions comprise about 50-60%V/V of PEG 400. According to a preferred embodiment of the presentinvention, the glycopeptide antibiotic solutions comprise about 50-60%V/V of PEG 300. According to a preferred embodiment of the presentinvention, glycopeptide antibiotic solutions comprise about 55% V/V ofPEG 400.

In a preferred embodiment, the solutions of the invention compriseVancomycin.

The present invention thus provides stable or stabilized glycopeptideantibiotic solutions, for example Vancomycin solutions. The stability ofa glycopeptide antibiotic solution according to the invention can bedetermined by measuring the amount of glycopeptide antibiotic, forexample Vancomycin, remaining in a solution of the invention after apredetermined time period, preferably expressed as a percentage, forexample as a peak-area percentage of a chromatogram as described in moredetail below. For example, a stable or stabilized solution according tothe invention can be one which has at least about 85%, 86%, 87%, 88%,89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.5% or 100% ofglycopeptide antibiotic, for example Vancomycin, remaining after apredetermined time period.

For example, the predetermined time period could be 18 months from themanufacture date. The predetermined antibiotic amount or predeterminedantibiotic purity could be any value as required according topharmaceutical guidelines or pharmaceutical authorities, like a givenchromatographic purity of the active ingredient as measured according tothe European Pharmacopoeia or USP.

Alternatively, the amount of glycopeptide antibiotic to glycopeptideantibiotic breakdown products, for example Vancomycin to Vancomycinbreakdown products, in the solution after a predetermined time periodcan be related to each other to express solution stability, preferablyas a percentage of glycopeptide antibiotic remaining or of glycopeptideantibiotic impurities formed. For example, a stable or stabilizedsolution according to the invention can be one which has at least about85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%,99%, 99.5% or 100% of glycopeptide antibiotic, for example Vancomycinremaining after a predetermined time period.

Stability of the present solutions can also be expressed as the amountof glycopeptide antibiotic, for example Vancomycin, impurities presentafter a predetermined time period. For example, a stable or stabilizedsolution according to the invention can be one which has no more thanabout 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%or 0.5% of impurities present after a predetermined time period.

It is not necessary to measure all types of glycopeptide antibioticbreakdown products present, for example Vancomycin breakdown productspresent. It is therefore contemplated by the present invention, in anexemplary embodiment, that stability of the present solutions can bedetermined by measuring the amount of DAMS (Formula 2) in the sampleafter a predetermined time period, and expressing that stability, forexample, as a percentage of Vancomycin remaining or of DAMS present.Likewise, it is contemplated by the present invention that stability ofthe present solutions can be determined by measuring the amount ofCDP1-m/M (Formulas 3a and 3b) in the sample after a predetermined timeperiod, and expressing that stability, for example, as a percentage ofVancomycin remaining or of DAMS and/or CDP1-m/M present. Theconcentration of the glycopeptide antibiotic or glycopeptide antibioticimpurities, for example Vancomycin or Vancomycin impurities, in thepresent solutions can be measured by any suitable techniques, andexpressed in any convenient units (i.e., chromatogram peak-areapercentage, millimolar, etc.). One skilled in the art would readilyunderstand that there are other ways to determine the percentage ofglycopeptide or glycopeptide breakdown products, for example Vancomycinor Vancomycin breakdown products, in solutions of the invention after apredetermined time period.

Stability of the present solutions can also be expressed in terms otherthan the percentage of glycopeptide antibiotic or glycopeptideantibiotic breakdown products, for example Vancomycin remaining or ofVancomycin breakdown products, in solution after a predetermined timepoint. Stability can also be expressed in terms of concentration orabsolute amount of either glycopeptide antibiotic (for example asVancomycin B) or of any glycopeptide antibiotic, for example Vancomycin,breakdown product or combination of breakdown products.

Stability can also be represented as the purity of the activeingredients in a solution of the invention. For example, if the solutioninitially contains the glycopeptide antibiotic in a certain purity, thestability of the solution will be reflected by a decrease in thechromatographic purity of the glycopeptide antibiotic over time. Astable solution would contain the glycopeptide antibiotic in a specifiedchromatographic purity after a predetermined time period. In Table 1,the initial chromatographic purity of Vancomycin is approximately 96%and decreases to approximately 87% during storage for 4 weeks at 25° C.in solutions that are not stabilized.

Suitable techniques for measuring the concentration of glycopeptideantibiotic, for example Vancomycin (generally measured as Vancomycin B)or glycopeptide antibiotic, for example Vancomycin, breakdown productsin the present solutions are known in the art, and include HPLC andother liquid chromatographic methods such as is disclosed in the UnitedStates Pharmacopeia National Formulary for Vancomycin Hydrochloride (USP36-NF 31). A preferred method for measuring the concentration ofglycopeptide antibiotics and glycopeptide antibiotic breakdown products,such as Vancomycin and/or Vancomycin breakdown products, is shown in theExamples below and is disclosed in the European pharmacopeia 8.0, pages3525-3527.

Stability of the present solutions can also be measured by testing theactivity of the glycopeptide antibiotic in the solution at the end of apredetermined time period. For example, the ability of the solution toinhibit bacterial growth can be measured and can be compared, forexample, to the activity of a portion of the solution tested at thebeginning of the predetermined time period. Alternatively, theglycopeptide antibiotic activity of a solution of the invention after apredetermined time period can be compared to that of a freshly made,identical solution or a control solution of glycopeptide antibiotic. Ina preferred embodiment, the present solutions comprise Vancomycin.Suitable methods for determining Vancomycin activity in solutions of theinvention include tests for determining minimum inhibitory concentrationof Vancomycin in a solution of the invention as against standard testorganisms, such as Staphylococcus aureus. A preferred method fordetermining Vancomycin activity in the present solutions is shown inExample 5 below.

The present invention provides stable or stabilized glycopeptideantibiotic solutions that can be transported, stored and used withoutspecial conditions (i.e, refrigeration) as formulated for up to twoyears from being produced. As used herein, a stable or stabilizedsolution of the invention can be a solution that is stable or stabilized(as discussed above) in the liquid state for between about one week and24 months. For example, a stable or stabilized solution of the inventioncan be a solution which is stable or stabilized (as discussed above) inthe liquid state for at least about one week, 2 weeks, 3 weeks, 4 weeks,5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks or 12weeks. For example, a stable or stabilized solution of the invention canbe a solution which is stable or stabilized (as discussed above) in theliquid state for at least up to about 3, 4, 5, 6, 8, 10, 12, 14, 16, 18,20, 21, 22, 23 or 24 months under normal conditions of shipping andstorage, i.e. at temperatures of about 25 degrees Celsius. In oneembodiment, solutions of the invention are stable or stabilized forabout 17, 18, 21 or 24 months at about 25 degrees Celsius.

The stable or stabilized solutions of the invention are suitable foradministration to a subject at any time during their stability period(for example, for between about one week and 24 months). Suitable foradministration to a subject means that the stable or stabilized solutionof the invention contains sufficient glycopeptide antibiotic, forexample Vancomycin, and is sufficiently free of impurities (includingglycopeptide antibiotic breakdown products) that the solution willproduce the desired therapeutic effect on the subject. Thus, theinvention provides a method of treating a bacterial infection in asubject, comprising administering a solution of the invention to asubject, so that a therapeutically effective amount of glycopeptideantibiotic is delivered. In a preferred embodiment, a therapeuticallyeffective amount of Vancomycin is delivered.

As used herein, a “therapeutically effective amount of glycopeptideantibiotic” is an amount which is sufficient to treat a subject'sbacterial infection. A bacterial infection is treated when one or moresymptoms of that infection remain substantially the same, areameliorated to any degree, or prevented from occurring. Treatment of abacterial infection also includes exhibition of bactericidal orbacteriostatic effects. A skilled medical practitioner is able to assesswhether a bacterial infection is being treated upon administration ofsolutions of the invention.

The treatment method according to the invention also includes deliveryof glycopeptide antibiotic to a subject such that certainpharmacokinetic parameters are met. For example, solutions of theinvention, if delivered by intravenous infusion, can produce thepharmacokinetic parameters described in Table 2 of Van Bambeke, F(2006), Curr. Opin. Invest. Drugs 7(8): 740-749, the disclosure of whichis herein incorporated by reference. In a preferred embodiment,solutions of the invention comprising Vancomycin, if delivered byintravenous infusion, can produce the pharmacokinetic parametersdescribed in the Vancomycin HCl for Injection package insert fromHospira, incorporated herein by reference. Thus, intravenous delivery ofsolutions of the invention to a subject can produce a mean plasmaconcentration of 63 micrograms/mL immediately after infusion of 1 gramVancomycin (15 mg/kg) over 60 minutes. Multiple dosing of 500 mgVancomycin infused over 30 minutes can produce a mean plasmaconcentration of about 49 microgram/mL at the completion of infusion,mean plasma concentrations of about 19 microgram/mL two hours afterinfusion, and mean plasma concentrations of about 10 microgram/mL sixhours after infusion.

It is understood that the solutions of the invention can be formulatedand delivered in any suitable manner, as is well-known in the art. Forexample, the present solutions can be administered parenterally; e.g.,by intravenous infusion. The present solutions can also be administeredenterally, for example orally.

Glycopeptide antibiotic compositions in liquid state according to thepresent invention include any pharmaceutically acceptable concentrationof glycopeptide antibiotic, for example Vancomycin. Further included isany concentration of glycopeptide antibiotic which upon dilution with asuitable diluent will provide a pharmaceutically acceptableconcentration. E.g the concentration of glycopeptide antibiotic, forexample Vancomycin, in the solutions according to the present inventioninclude about 0.1-20% w/V, 0.5-20% w/V 3-15% w/V, 5-15% w/V, or 3-10%w/V. The preferred concentration of glycopeptide antibiotic, for exampleVancomycin, in the solutions according to the present invention includeabout 0.5-15% w/V. Even more preferred concentration of glycopeptideantibiotic, for example in the solutions according to the presentinvention include about 0.5-10% w/V. Also preferred are solutionscomprising about 0.5% w/V, about 5% w/V or about 10% w/V glycopeptideantibiotic, for example Vancomycin.

According to the present invention, the suitable molar ratio of anN-acetylated-D-amino acid to glycopeptide antibiotic, for exampleVancomycin, is about 0.5:1 to 40:1. According to the present invention,a preferred molar ratio of an N-acetylated-D-amino acid to glycopeptideantibiotic, for example Vancomycin, is about 1:1 to 20:1. According tothe present invention, a preferred molar ratio of anN-acetylated-D-amino acid to glycopeptide antibiotic, for exampleVancomycin, is about 1:1 to 30:1

According to the present invention, the suitable molar ratio ofN-acetyl-D-Alanine to glycopeptide antibiotic, for example Vancomycin,is about 0.5:1 to 40:1. According to the present invention, a preferredmolar ratio of N-acetyl-D-Alanine to glycopeptide antibiotic, forexample Vancomycin, is about 1:1 to 20:1. According to the presentinvention, a preferred molar ratio of N-acetyl-D-Alanine to glycopeptideantibiotic, for example Vancomycin, is about 1:1 to 30:1.

According to the present invention, the suitable molar ratio ofN-acetyl-D-Alanine to glycopeptide antibiotic, for example Vancomycin,is about 5:1 to 40:1 for a solution comprising about 0.5% w/V ofglycopeptide antibiotic. According to the present invention, a preferredmolar ratio of N-acetyl-D-Alanine to glycopeptide antibiotic, forexample Vancomycin, is about 30:1 for a solution comprising about 0.5%w/V glycopeptide antibiotic.

According to the present invention, the suitable molar ratio ofN-acetyl-D-Alanine to glycopeptide antibiotic, for example Vancomycin,is about 0.1:1 to 10:1 for a solution comprising about 5% w/Vglycopeptide antibiotic. According to the present invention, a preferredmolar ratio of N-acetyl-D-Alanine to glycopeptide antibiotic, forexample Vancomycin, is about 2:1 for a solution comprising about 5% w/Vglycopeptide antibiotic.

According to the present invention, the suitable molar ratio ofN-acetyl-Glycine to glycopeptide antibiotic, for example Vancomycin, isabout 0.5:1 to 40:1. According to the present invention, a preferredmolar ratio of N-acetyl-Glycine to glycopeptide antibiotic, for exampleVancomycin, is about 1:1 to 30:1. According to the present invention, apreferred molar ratio of N-acetyl-Glycine to glycopeptide antibiotic,for example Vancomycin, is about 1:1 to 20:1.

According to the present invention, the suitable molar ratio of an aminoacid to glycopeptide antibiotic, for example Vancomycin, is about 0.5:1to 40:1. According to the present invention, a preferred molar ratio ofan amino acid to glycopeptide antibiotic, for example Vancomycin, isabout 1:1 to 30:1. According to the present invention, a preferred molarratio of an amino acid to glycopeptide antibiotic, for exampleVancomycin, is about 1:1 to 20:1.

As used herein, a “suitable molar ratio” is the molar ratio of anexcipient to glycopeptide antibiotic, for example Vancomycin, in thesolutions of the invention which allows the formation of a stable orstabilized solution of the invention as defined herein, and includes themolar ratios described in the above paragraphs.

The stable or stabilized glycopeptide antibiotic compositions accordingto the present invention include optionally an amino acid. In apreferred embodiment, the stable or stabilized glycopeptide antibioticcompositions according to the present invention comprise Vancomycin andinclude optionally an amino acid.

The preferred amino acids include Alanine, Serine, Leucine, Valine,Lysine, Arginine and Ornithine. The most preferred amino acids includeD-Alanine, D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine,L-Ornithine, D-Ornithine or L-Arginine.

The amino acids can be added to the compositions in the form ofpharmaceutically acceptable salts. E.g. L-Lysine can be added to thecompositions in the form of the chloride salt; L-Lysine hydrochloride.L-Lysine can also be added to the compositions in the form of an acetatesalt; L-Lysine acetate.

The most preferred N-acetylated amino acid derivatives includeN-acetyl-Glycine and N-acetyl-D-Alanine.

Among the many formulations provided according to the present invention,the following are also included:

-   -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:0.5-1:20 having a pH of about 3-6 further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:20 having a pH of about 3-6 further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:30 having a pH of about 3-6 further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:20 having a pH of about 3-6 further        comprising an amino acid selected from Serine, Leucine, Valine,        Lysine, Arginine and Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:30 having a pH of about 3-6 further        comprising an amino acid selected from Serine, Leucine, Valine,        Lysine, Arginine and Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of 3-6 further comprising an        amino acid selected from Serine, Leucine, Valine, Lysine,        Arginine and Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:20 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:30 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/v        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:20 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of        1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:20 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:30 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:30 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1; further comprising about 5-30% V/V of an        pharmaceutically acceptable organic solvent.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1; further comprising about 5-50% V/V of an        pharmaceutically acceptable organic solvent.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid selected from D-Serine, D-Leucine,        D-Valine, L-Lysine, D-Lysine, L-Arginine, D-Ornithine or        L-Ornithine in a molar ratio to glycopeptide antibiotic of        1:1-30:1; further comprising about 10% v/v of ethanol.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in the molar        ratio of 1:1-1:40 having a pH of about 3-6 further comprising an        amino acid selected from D-Serine, D-Leucine, D-Valine,        L-Lysine, D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a        molar ratio to glycopeptide antibiotic of about 1:1-30:1;        further comprising about 5-50% v/v of polyethylene glycol.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:1-1:20 having a pH of about 3-6 further comprising an        amino acid selected from L-Lysine, D-Lysine, L-Arginine,        L-Ornithine or D-Ornithine in a molar ratio to glycopeptide        antibiotic of about 1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:1-1:30 having a pH of about 3-6 further comprising an        amino acid selected from L-Lysine, D-Lysine, L-Arginine,        L-Ornithine or D-Ornithine in a molar ratio to glycopeptide        antibiotic of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:1-1:40 having a pH of about 3-6 further comprising an        amino acid selected from L-Lysine, D-Lysine, L-Arginine,        L-Ornithine or D-Ornithine in a molar ratio to glycopeptide        antibiotic of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:1-1:30 having a pH of about 3-6 further comprising        L-Lysine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:1-1:40 having a pH of about 3-6 further comprising        L-Lysine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.1-1% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:5-1:40 having a pH of about 3-6 further comprising        L-Lysine in a molar ratio to glycopeptide antibiotic of about        1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in molar ratio        about 1:30 having a pH of about 4.5-6.5 further comprising        L-Lysine in a molar ratio to glycopeptide antibiotic of about        1:20.    -   Aqueous pharmaceutical compositions comprising about 0.5% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in a molar ratio        about 1:30 having a pH of about 4-6 further comprising L-Lysine        in a molar ratio to glycopeptide antibiotic of about 1:20.    -   Aqueous pharmaceutical compositions comprising about 0.5% w/V        glycopeptide antibiotic and N-acetyl-D-Alanine in a molar ratio        about 1:30 having a pH of about 4.5-5.5 further comprising        L-Lysine in a molar ratio to glycopeptide antibiotic of about        1:20.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and an N-modified-D-amino acid in the        molar ratio of about 1:1-1:20 having a pH of about 3-6        optionally further comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and an N-modified-D-amino acid in the        molar ratio of about 1:1-1:30 having a pH of about 3-6        optionally further comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and an N-modified-D-amino acid in the        molar ratio of about 1:1-1:40 having a pH of about 3-6        optionally further comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        glycopeptide antibiotic and an N-modified-D-amino acid in the        molar ratio of about 1:1-1:40 having a pH of about 3-6 further        comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to glycopeptide antibiotic of about 1:1-20:1; further        comprising about 10% V/V of ethanol.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to glycopeptide antibiotic of about 1:1-20:1; further        comprising about 10% V/V of ethanol.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to glycopeptide antibiotic of about 1:1-30:1; further        comprising about 10% V/V of ethanol.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 further comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 further comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 further comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 4-6 further comprising L-Lysine in        the molar ratio of about 1:1-1:30 and further about 50-60% V/V        polyethylene glycol and water q.s.    -   Compositions comprising about 0.5-15% w/V glycopeptide        antibiotic and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 5-6 further comprising L-Lysine in        the molar ratio of about 1:1-1:30 and further about 50-60% V/V        PEG 400 or PEG 300 and water q.s.    -   Compositions comprising about 5% w/V glycopeptide antibiotic and        N-acetyl-D-Alanine in the molar ratio of about 1:2 having a pH        of about 4-6 further comprising L-Lysine in the molar ratio of        about 1:2 and further about 55% V/V PEG 400 and water q.s.    -   Compositions comprising about 5% w/V glycopeptide antibiotic and        N-acetyl-D-Alanine in the molar ratio of about 1:2 having a pH        of about 4.5-5.5 further comprising L-Lysine in the molar ratio        of about 1:2 and further about 55% V/V PEG 400 and water q.s.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:0.5-1:20 having a pH of about 3-6 further comprising an amino        acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid.    -   Aqueous pharmaceutical compositions comprising 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid selected from Serine, Leucine, Valine, Lysine, Arginine and        Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid selected from Serine, Leucine, Valine, Lysine, Arginine and        Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of 3-6 further comprising an amino acid        selected from Serine, Leucine, Valine, Lysine, Arginine and        Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/v        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of 1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:20 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:30 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-30:1; further comprising about        5-30% V/V of an pharmaceutically acceptable organic solvent.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of about 1:1-30:1; further comprising about        5-50% V/V of an pharmaceutically acceptable organic solvent.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of about        1:1-1:40 having a pH of about 3-6 further comprising an amino        acid selected from D-Serine, D-Leucine, D-Valine, L-Lysine,        D-Lysine, L-Arginine, D-Ornithine or L-Ornithine in a molar        ratio to Vancomycin of 1:1-30:1; further comprising about 10%        v/v of ethanol.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in the molar ratio of 1:1-1:40        having a pH of about 3-6 further comprising an amino acid        selected from D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine,        L-Arginine, D-Ornithine or L-Ornithine in a molar ratio to        Vancomycin of about 1:1-30:1; further comprising about 5-50% v/v        of polyethylene glycol.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:1-1:20        having a pH of about 3-6 further comprising an amino acid        selected from L-Lysine, D-Lysine, L-Arginine, L-Ornithine or        D-Ornithine in a molar ratio to Vancomycin of about 1:1-20:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:1-1:30        having a pH of about 3-6 further comprising an amino acid        selected from L-Lysine, D-Lysine, L-Arginine, L-Ornithine or        D-Ornithine in a molar ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:1-1:40        having a pH of about 3-6 further comprising an amino acid        selected from L-Lysine, D-Lysine, L-Arginine, L-Ornithine or        D-Ornithine in a molar ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:1-1:30        having a pH of about 3-6 further comprising L-Lysine in a molar        ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:1-1:40        having a pH of about 3-6 further comprising L-Lysine in a molar        ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.1-1% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:5-1:40        having a pH of about 3-6 further comprising L-Lysine in a molar        ratio to Vancomycin of about 1:1-30:1.    -   Aqueous pharmaceutical compositions comprising about 0.5% w/V        Vancomycin and N-acetyl-D-Alanine in molar ratio about 1:30        having a pH of about 4.5-6.5 further comprising L-Lysine in a        molar ratio to Vancomycin of about 1:20.    -   Aqueous pharmaceutical compositions comprising about 0.5% w/V        Vancomycin and N-acetyl-D-Alanine in a molar ratio about 1:30        having a pH of about 4-6 further comprising L-Lysine in a molar        ratio to Vancomycin of about 1:20.    -   Aqueous pharmaceutical compositions comprising about 0.5% w/V        Vancomycin and N-acetyl-D-Alanine in a molar ratio about 1:30        having a pH of about 4.5-5.5 further comprising L-Lysine in a        molar ratio to Vancomycin of about 1:20.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and an N-modified-D-amino acid in the molar ratio of        about 1:1-1:20 having a pH of about 3-6 optionally further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and an N-modified-D-amino acid in the molar ratio of        about 1:1-1:30 having a pH of about 3-6 optionally further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and an N-modified-D-amino acid in the molar ratio of        about 1:1-1:40 having a pH of about 3-6 optionally further        comprising an amino acid.    -   Aqueous pharmaceutical compositions comprising about 0.5-15% w/V        Vancomycin and an N-modified-D-amino acid in the molar ratio of        about 1:1-1:40 having a pH of about 3-6 further comprising an        amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:20 having a        pH of about 3-6 further comprising an amino acid selected from        D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine, L-Arginine,        D-Ornithine or L-Ornithine in a molar ratio to Vancomycin of        about 1:1-20:1; further comprising about 10% V/V of ethanol.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:30 having a        pH of about 3-6 further comprising an amino acid selected from        D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine, L-Arginine,        D-Ornithine or L-Ornithine in a molar ratio to Vancomycin of        about 1:1-20:1; further comprising about 10% V/V of ethanol.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:40 having a        pH of about 3-6 further comprising an amino acid selected from        D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine, L-Arginine,        D-Ornithine or L-Ornithine in a molar ratio to Vancomycin of        about 1:1-30:1; further comprising about 10% V/V of ethanol.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:20 further        comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:30 further        comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:40 further        comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:20 having a        pH of about 3-6 further comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:30 having a        pH of about 3-6 further comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:40 having a        pH of about 3-6 further comprising an amino acid.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:40 having a        pH of about 4-6 further comprising L-Lysine in the molar ratio        of about 1:1-1:30 and further about 50-60% V/V polyethylene        glycol and water q.s.    -   Compositions comprising about 0.5-15% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:1-1:40 having a        pH of about 5-6 further comprising L-Lysine in the molar ratio        of about 1:1-1:30 and further about 50-60% V/V PEG 400 or PEG        300 and water q.s.    -   Compositions comprising about 5% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:2 having a pH        of about 4-6 further comprising L-Lysine in the molar ratio of        about 1:2 and further about 55% V/V PEG 400 and water q.s.    -   Compositions comprising about 5% w/V Vancomycin and        N-acetyl-D-Alanine in the molar ratio of about 1:2 having a pH        of about 4.5-5.5 further comprising L-Lysine in the molar ratio        of about 1:2 and further about 55% V/V PEG 400 and water q.s.

The invention also provides methods of stabilizing glycopeptideantibiotic, for example Vancomycin, in a pharmaceutical solution of theinvention, comprising mixing N-acetyl-D-Alanine or N-acetyl Glycine andVancomycin. The order in which these components are mixed is notcritical. Thus, N-acetyl-D-Alanine or N-acetyl Glycine can be added to asolution comprising glycopeptide antibiotic, or glycopeptide antibioticcan be added to a solution comprising N-acetyl-D-Alanine orN-acetyl-Glycine. In a preferred embodiment, N-acetyl-D-Alanine is addedto a solution comprising glycopeptide antibiotic or glycopeptideantibiotic is added to a solution comprising N-acetyl-D-Alanine. Theinvention also provides methods of manufacturing a stable aqueousglycopeptide antibiotic, for example Vancomycin, pharmaceutical solutioncomprising the steps of mixing glycopeptide antibiotic and an excipientselected from N-acetyl-D-Alanine or N-acetyl-Glycine. Again, the orderin which these components are mixed is not critical. In a preferredembodiment, the components are mixed in the order Vancomycinbase+diluted HCl in a stoichiometric amount+N-Acetyl-D-Alanine, as thisresults in a complete conversion of Vancomycin base to Vancomycinhydrochloride. Nonlimiting exemplary methods to stabilize Vancomycin ormanufacture solutions according to the invention are shown in theExamples below.

Solutions stabilized or manufactured according to methods of theinvention can be made suitable for use with human or animal subjects bytechniques known in the art, for example by sterilizing the solution byany suitable means, and packaging the solutions in sealed containersfrom which the solution can later be dispensed to the subject.

The invention further provides kits comprising the solutions of theinventions. The kits can comprise one or more containers holdingsolutions of the invention, preferably ready to use in treatment of abacterial infection in a subject. However, it is also contemplated thatthe solutions in the one or more containers can be diluted with apharmaceutically acceptable diluent before administration to a subject.The kits can further comprise materials, one or more devices or one ormore apparatuses for dispensing or delivering the solutions of theinvention to a subject, or for diluting the present solutions. The kitsmay further comprise instructions for the storage and/or use of thesolutions of the invention.

In some embodiments, the concentration of glycopeptide antibiotic can bedetermined by the method disclosed in the Examples below. In otherembodiments, the concentration of glycopeptide antibiotic can bedetermined by the methods disclosed in the United States PharmacopeiaNational Formulary for Vancomycin Hydrochloride (USP 36).

Solution A: Triethylamine and water (1:500). Adjust with phosphoric acidto a pH of 3.2.

Solution B: Acetonitrile, tetrahydrofuran, and Solution A (7:1:92)

Solution C: Acetonitrile, tetrahydrofuran, and Solution A (29:1:70)

Mobile phase: See the gradient table below. [NOTE—Make adjustments ifnecessary, changing the acetonitrile proportion in Solution B to obtaina retention time of 7.5-10.5 min for the main vancomycin peak.]

Time (min) Solution B (%) Solution C (%) 0 100 0 12 100 0 20 0 100 22 0100 23 100 0 30 100 0

System suitability solution: 0.5 mg/mL of USP Vancomycin HydrochlorideRS in water. Heat at 65° for 48 h, and allow to cool.

Sample solution 1: 10 mg/mL of Vancomycin Hydrochloride in Solution B

Sample solution 2: 0.4 mg/mL of Vancomycin Hydrochloride, from Samplesolution 1 in Solution B

Chromatographic system

(See Chromatography (621), System Suitability.)

Mode: LC

Detector: UV 280 nm

Column: 4.6-mm×25-cm; 5 μm packing L1

Flow rate: 2 mL/min

Injection size: 20 μL

System Suitability

Sample: System suitability solution

[NOTE—The elution order is compound 1, vancomycin B, and compound 2.Compound 2 elutes 3-6 min after the start of the period when thepercentage of Solution C increases from 0%-100%.]

Suitability Requirements

Resolution: NLT 3.0 between compound 1 and vancomycin B

Column efficiency: NLT 1500 theoretical plates, calculated from thevancomycin B peak Analysis

Samples: Sample solution 1 and Sample solution 2

[NOTE—Where baseline separation is not achieved, peak areas are definedby vertical lines extended from the valleys between the peaks to thebaseline. The main component peak may include a fronting shoulder, whichis attributed to monodechlorovancomycin. This shoulder should not beintegrated separately.]

Measure the area responses for all the peaks. Calculate the percentageof vancomycin B in the portion of Vancomycin Hydrochloride taken:Result=[(D×r _(B))/((D×r _(B))+r _(A))]×100D=dilution factor, Sample solution 1 to Sample solution 2, 25r₃=corrected area response of the main peak of Sample solution 2r_(A)=sum of the corrected area responses of all the peaks, other thanthe main peak, from Sample solution 1

Calculate the percentage of each other peak in the portion of VancomycinHydrochloride taken:Result=[(r ₁ /D×r _(B))]×100r₁=corrected area response of any individual peak, other than the mainpeak of Sample solution 1D=dilution factor, Sample solution 1 to Sample solution 2, 25r_(B)=corrected are response of the main peak of Sample solution 2r_(A)=sum of the corrected area responses of all the peaks, other thanthe main peak from Sample solution 1Acceptance criteria: NLT 85.0% of vancomycin B; NMT 5.0% of any peakother than the main peak

The invention is illustrated by the following non-limiting examples:

EXAMPLES

The stabilizing effect of different factors such as use of amino acidsin aqueous Vancomycin compositions, Vancomycin concentration and pH ofthe aqueous pharmaceutical composition, molar ratio of Vancomycin toamino acids and use of organic solvents (such as ethanol, PEG 300 andPEG 400) under standardized stability testing conditions were evaluated.

General Techniques

All formulations presented in examples below were prepared with thestarting volume of ultrapure water equal to about 50%-80% of the finalbatch volume. Presented aqueous Vancomycin compositions comprisedbetween 0.5%-10% (w/V) of Vancomycin.

Certain aqueous pharmaceutical compositions comprised a pH adjustingagent. When required, pH was adjusted using diluted HCl and/or NaOHsolutions.

“Basic Vancomycin” formulations (5% and 10% Vancomycin, w/V) andformulations without N-acetyl-D-Alanine or N-acetyl-Glycine are shownfor comparative purposes. All solutions were tested using validated HPLCmethods able to quantify Vancomycin purity (Vancomycin B content) andthe two main degradation impurities DAMS and CDP1. The solutions wereanalyzed immediately after preparation (start analysis), filled intovials, stoppered and stored for 4 weeks at 25±2° C./60±5% RH or 30±2° C.and retested after a predetermined time period expired.

The HPLC conditions used were those disclosed in the EuropeanPharmacopeia 8.0, pages 3525-3527, employing acceptable variations tothe conditions as would be understood by those skilled in the art forcertain sample, using the following conditions:

Vancomycin B liquid chromatography (2.2.29). The solutions were usedwithin 4 hours of preparation.

Test solution (a). Dissolved 10.0 mg of the substance to be examined inmobile phase A and diluted to 5.0 mL with mobile phase A.

Test solution (b). Diluted 2.0 mL of test solution (a) to 50.0 mL withmobile phase A.

Test solution (c). Diluted 0.5 mL of test solution (b) to 20.0 mL withmobile phase A.

Reference solution. Dissolved the contents of a vial of VancomycinHydrochloride CRS in water R and diluted with the same solvent to obtaina solution containing 0.5 mg/mL. Heated at 65° C. for 24 h. Allowed tocool. Column:

size: 1=0.25 m, Ø=4.6 mm

stationary phase: octadecylsilyl silica gel for chromatography R (5 pm).

Mobile Phase:

Mobile phase A: to 4 mL of triethylamine R added 1996 mL of water R andadjusted to pH 3.2 with phosphoric acid R; to 920 mL. of this solutionwas added 10 mL. of tetrahydrofuran R and 70 mL of acetonitrile R.

Mobile phase B: to 4 mL of triethylamine R was added 1996 mL of water Rand adjusted to pH 3.2 with phosphoric acid R; to 700 mL of thissolution was added 10 mL. of tetrahydrofuran R and 290 mL ofacetonitrile R.

Time Mobile phase A Mobile phase B (min) (percent V/V) (percent V/V) 0-13 100 0 13-22 100 -> 0 0 -> 100Flow rate: 1.0 mL/min.Detection: spectrophotometer at 280 nm.Injection: 20 μL.

System Suitability:

resolution: minimum 5.0 between the 2 principal peaks in thechromatogram obtained with the reference solution;

signal-to-noise ratio: minimum 5 for the principal peak in thechromatogram obtained with test solution (c);

symmetry factor: maximum 1.6 for the peak due to Vancomycin in thechromatogram obtained with test solution (b).

Calculated the percentage content of Vancomycin B hydrochloride usingthe following expression:(Ab×100)/(Ab+(At/25))

Ab=area of the peak due to Vancomycin B in the chromatogram obtainedwith test solution (b);

At=sum of the areas of the peaks due to impurities in the chromatogramobtained with test solution (a).

Related substances. Liquid chromatography (2.2.29) was performed asdescribed in the test for Vancomycin B with the following modifications:

Injection: test solution (a), (b) and (c).

Calculated the percentage content of each impurity using then followingexpression:

((Ai/25)×100)/(Ab+(At/25))

Ai=area of the peak due to an impurity in the chromatogram obtained withtest solution (a);

Ab=area of the peak due to Vancomycin B in the chromatogram obtainedwith test solution (b);

At=sum of the areas of the peaks due to impurities in the chromatogramobtained with test solution (a).

Example 1—Stabilization Effect of Amino Acids

Aqueous pharmaceutical compositions of Vancomycin base and Vancomycinhydrochloride were prepared in predetermined concentrations and incertain compositions (as shown below). Solution pH was further adjustedusing diluted HCl solution or diluted NaOH solution. After Vancomycinand amino acids were added into the solution in the molar ratiosspecified in Table 1 below, the solution was mixed until the substanceswere dissolved.

TABLE 1 Purity (%) DAMS (%) CDP1 (%) Vancomycin 4 weeks at 4 weeks at 4weeks at Composition conc. (%) Molar ratio pH START 25° C. START 25° C.START 25° C. Vancomycin HCl 5 / 3.13 96.3 86.6 0.6 4.5 0.2 6.0Vancomycin HCl 10 / 3.05 96.2 87.5 0.7 4.3 0.2 5.2 N-acetyl-D-Alanine +5 2:1 3.06 96.5 94.9 0.6 1.2 0.2 1.1 Vancomycin base + 4M HCl^(#)N-acetyl-D-Alanine + 5 2:1 3.22 96.5 95.3 0.6 1.1 0.2 0.9 Vancomycinbase L-Serine + Vancomycin 10 2:1 2.98 96.2 87.6 0.6 4.1 0.2 5.2 HCl +4M HCl^(#) D-Serine + Vancomycin 10 2:1 3.00 96.2 89.6 0.6 3.4 0.2 4.3HCl + 4M HCl^(#) N-acetyl-D-Alanine + D-Serine + 5 2:2:1 3.31 96.5 95.30.6 0.8 0.2 0.8 Vancomycin base D-Leucine+ Vancomycin 10 1:1 3.02 96.289.2 0.6 3.4 0.2 4.3 HCl + 4M HCl^(#) N-acetyl-D-Alanine + D-Leucine + 52:2:1 3.40 96.5 95.6 0.6 0.8 0.2 0.7 Vancomycin base L-Lysine +Vancomycin 10 2:1 3.03 96.5 87.6 0.7 3.9 0.1 4.9 HCl + 4M HCl^(#)L-Lysine + D-Alanine + Vancomycin 10 2:2:1 2.98 96.5 93.7 0.7 1.5 0.11.7 HCl + 4M HCl^(#) L-Lysine + L-Alanine + Vancomycin 10 2:2:1 3.0096.1 91.7(*) 0.6 3.1(*) 0.2 2.1(*) HCl + 4M HCl^(#) L-Lysine + Glycine +Vancomycin 10 2:2:1 3.00 96.2 91.3(*) 0.6 3.2(*) 0.2 2.5(*) HCl + 4MHCl^(#) N-acetyl-D-Alanine + L-Lysine + 5 2:2:1 3.05 96.5 94.8 0.6 1.00.2 1.1 Vancomycin HCl + 4M HCl^(#) N-acetyl-D-Alanine + L-Lysine + 52:2:1 4.41 96.4 96.1 0.6 0.7 0.2 0.5 Vancomycin HCl N-acetyl-Glycine +L-Lysine + 10 2:2:1 2.99 96.1 94.3 0.6 1.3 0.3 1.5 Vancomycin HCl + 4MHCl^(#) L-Arginine + Vancomycin 10 2:1 3.00 96.4 92.0(*) 0.6 3.1(*) 0.32.1(*) HCl + 4M HCl^(#) N-acetyl-D-Alanine + L-Arginine + 5 2:2:1 4.0596.5 95.9 0.6 0.7 0.2 0.6 Vancomycin HCl Vancomycin HCl + D-Lysine + 51:2:2 5.45 96.2 95.8 0.6 0.6 0.2 0.6 N-acetyl-D-Alanine + 0.4M NaOH^(#)Vancomycin HCl + D-Ornithine + N- 5 1:2:2 5.48 96.2 95.8 0.6 0.6 0.2 0.7acetyl-D-Alanine +2 M/0.4M NaOH^(#) Vancomycin HCl + L-Ornithine + N- 51:2:2 5.49 96.2 95.8 0.6 0.6 0.2 0.7 acetyl-D-Alanine + 2M/0.4M NaOH^(#)Vancomycin HCl + L-Lysine 5 1:2:2 5.54 96.3 95.9 0.6 0.7 0.2 0.7monohydrate + N-acetyl-D-Alanine + 0.5M NaOH^(#) Vancomycin HCl +L-Lysine 5 1:2:2 5.46 96.4 95.8 0.6 0.6 0.2 0.6 monohydrochloride +N-acetyl-D- Alanine + 2M/0.5M NaOH^(#) Vancomycin HCl + L-Lysine 5 1:2:25.48 96.3 95.6 0.6 0.7 0.3 0.9 acetate + N-acetyl-D-Alanine + 2M/0.5MNaOH^(#) ^(#)Used as pH adjusting agent (*)2 weeks data (at 25 ± 2°C./60 ± 5% RH)

Example 2—Stabilization Effect of Vancomycin Concentration and pH of thePreparation

Aqueous pharmaceutical compositions of Vancomycin were prepared invarying concentrations, and in certain formulations pH was furtheradjusted using diluted HCl solution and/or diluted NaOH solution. AfterVancomycin and amino acids were added into the solution in the molarratios specified in Table 2 below, the solution was mixed untilsubstances were dissolved.

TABLE 2 Purity (%) DAMS (%) CDP1 (%) Vancomycin Molar 4 weeks at 4 weeksat 4 weeks at Composition conc. (%) ratio pH START 25° C. START 25° C.START 25° C. Vancomycin HCl 5 / 3.13 96.3 86.6 0.6 4.5 0.2 6.0Vancomycin HCl 10 / 3.05 96.2 87.5 0.7 4.3 0.2 5.2 N-acetyl-D-Alanine +L-Lysine + 0.5 2:2:1 3.96 96.5 92.2 0.6 1.7 0.2 3.3 Vancomycin HCl + 2MHCl^(#) Vancomycin HCl + L-Lysine + 2.5 1:2:2 5.57 96.4 95.1 0.6 0.6 0.31.5 N-acetyl-D-Alanine + 0.4M NaOH^(#) N-acetyl-D-Alanine + L-Lysine + 52:2:1 5.45 96.5 96.1 0.6 0.6 0.2 0.6 Vancomycin HCl + 1M NaOH^(#)Vancomycin HCl + L-Lysine + 3 1:2:2 5.52 96.4 95.6 0.6 0.7 0.2 0.9N-acetyl-D-Alanine + 0.4M NaOH^(#) Vancomycin HCl + L-Lysine + 4 1:2:25.47 96.4 95.8 0.6 0.6 0.2 0.7 N-acetyl-D-Alanine + 0.4M NaOH^(#)N-acetyl-D-Alanine + L-Lysine + 5 2:2:1 3.05 96.5 94.8 0.6 1.0 0.2 1.1Vancomycin HCl + 4M HCl^(#) N-acetyl-D-Alanine + Vancomycin 5 2:1 3.0696.5 94.9 0.6 1.2 0.2 1.1 base + 4M HCl^(#) Vancomycin HCl + L-Lysine +5 1:2:2 4.08 96.5 96.0 0.6 0.7 0.2 0.6 N-acetyl-D-AlanineN-acetyl-D-Alanine + L-Lysine + 5 2:2:1 4.41 96.4 96.1 0.6 0.7 0.2 0.5Vancomycin HCl N-acetyl-D-Alanine + L-Lysine + 5 2:2:1 4.43 96.5 96.10.6 0.7 0.2 0.5 Vancomycin HCl + 4M HCl^(#) + 1M NaOH^(#) VancomycinHCl + L-Lysine + 5 1:2:2 4.97 96.3 95.8 0.6 0.7 0.2 0.6N-acetyl-D-Alanine + 0.4M NaOH^(#) Vancomycin HCl + L-Lysine + 5 1:2:25.56 96.3 95.8 0.6 0.6 0.2 0.7 N-acetyl-D-Alanine + 0.4M NaOH^(#)Vancomycin HCl + N-acetyl-D- 5 1:2 7.89 96.3 93.9 0.6 0.4 0.3 2.7Alanine + 1M NaOH^(#) ^(#)Used as pH adjusting agent

Example 3—Stabilization Effect of Molar Ratio of Vancomycin and AminoAcids Present in the Aqueous Pharmaceutical Compositions

Aqueous pharmaceutical compositions of Vancomycin hydrochloride wereprepared in varying concentrations, and in certain formulations pH wasfurther adjusted using diluted HCl solution and/or diluted NaOHsolution. After Vancomycin and amino acids were added into the solutionin the molar ratios specified in Table 3 below, the solution was mixeduntil substances were dissolved.

TABLE 3 Purity (%) DAMS (%) 4 4 weeks weeks Vancomycin Molar at 4 weeksat 4 weeks Composition conc. (%) ratio pH START 25° C. at 30° C. START25° C. at 30° C. Vancomycin HCl 5 / 3.13 96.3 86.6 85.6(*) 0.6 4.55.1(*) Vancomycin HCl 10 / 3.05 96.2 87.5 87.2(*) 0.7 4.3 4.8(*)Vancomycin HCl + 5 1:1.5:1.5 4.04 96.3 95.8 95.0 0.6 0.8 0.9 L-Lysine +N-acetyl- D-Alanine Vancomycin HCl + 5 1:2:2 4.08 96.5 96.0 95.6 0.6 0.70.8 L-Lysine + N-acetyl- D-Alanine Vancomycin HCl + 5 1:1.5:3 3.31 96.395.7 95.0 0.6 0.7 0.8 L-Lysine + N-acetyl-D- Alanine Vancomycin HCl + 51:1:1.5 3.32 96.3 95.1 93.9 0.6 1.0 1.1 L-Lysine + N-acetyl-D-AlanineN-acetyl-D-Alanine + 10 1:1:1 2.98 96.1 95.2 93.6 0.6 1.0 1.3 L-Lysine +Vancomycin HCl + 4M HCl^(#) N-acetyl-D-Alanine + 5 2:2:1 5.45 96.5 96.195.7 0.6 0.6 0.6 L-Lysine + Vancomycin HCl + 1M NaOH^(#) VancomycinHCl + 5 1:3:3 5.44 96.3 96.1 95.9 0.6 0.6 0.6 L-Lysine + N-acetyl-D-Alanine + 0.4M NaOH^(#) Vancomycin HCl + 5 1:3:3 3.19 96.3 95.5 94.50.6 0.7 0.8 L-Lysine + N-acetyl- D-Alanine + 2M/0.4M HCl^(#) VancomycinHCl + 5 1:3:2 5.55 96.2 95.9 95.4 0.6 0.6 0.6 L-Lysine + N-acetyl-D-Alanine + 2M/0.4M HCl^(#) Vancomycin HCl + 5 1:3:2 3.22 96.3 95.1 93.80.6 0.9 1.0 L-Lysine + N-acetyl-D-Alanine + 2M HCl^(#) Vancomycin HCl +0.5 1:10:10 5.52 96.4 95.4 94.6 0.6 0.6 0.6 L-Lysine + (inN-acetyl-D-Alanine + 0.9% 0.4M NaOH^(#) NaCl) Vancomycin HCl + 0.51:20:20 5.53 96.4 95.6 95.3 0.6 0.6 0.6 L-Lysine + (inN-acetyl-D-Alanine + 0.9% 0.4M NaOH^(#) NaCl) Vancomycin HCl + 0.51:30:30 5.54 96.4 96.0 95.7 0.6 0.6 0.6 L-Lysine + (inN-acetyl-D-Alanine + 0.9% 0.5M HCl^(#) NaCl) Vancomycin HCl + 0.51:20:30 5.50 96.4 95.9 95.6 0.6 0.6 0.6 L-Lysine + (inN-acetyl-D-Alanine + 0.9% 2M/0.4M NaOH^(#) NaCl) Vancomycin HCl + 0.51:20:20 5.51 96.3 95.8 95.2 0.6 0.6 0.6 L-Lysine HCl + (inN-acetyl-D-Alanine + 0.9% 2M/1M/0.4M NaCl) NaOH^(#) Vancomycin HCl + 0.51:20:30 5.49 96.4 96.0 na 0.5 0.6 na L-Lysine HCl + (inN-acetyl-D-Alanine + 0.9% 2M NaOH^(#) NaCl) CDP1 (%) 4 weeks 4 weeksComposition START at 25° C. at 30° C. Vancomycin HCl 0.2 6.0 6.2(*)Vancomycin HCl 0.2 5.2 5.1(*) Vancomycin HCl + L-Lysine +N-acetyl-D-Alanine 0.2 0.7 1.4 Vancomycin HCl + L-Lysine +N-acetyl-D-Alanine 0.2 0.6 1.0 Vancomycin HCl + L-Lysine +N-acetyl-D-Alanine 0.2 0.6 1.3 Vancomycin HCl + L-Lysine +N-acetyl-D-Alanine 0.2 1.1 2.2 N-acetyl-D-Alanine + L-Lysine +Vancomycin HCl + 4M HCl^(#) 0.3 1.0 2.2 N-acetyl-D-Alanine + L-Lysine +Vancomycin HCl + 1M NaOH^(#) 0.2 0.6 1.0 Vancomycin HCl + L-Lysine +N-acetyl-D-Alanine + 0.4M NaOH^(#) 0.2 0.5 0.7 Vancomycin HCl +L-Lysine + N-acetyl-D-Alanine + 2M/0.4M HCl^(#) 0.2 0.7 1.5 VancomycinHCl + L-Lysine + N-acetyl-D-Alanine + 2M/0.4M HCl^(#) 0.2 0.7 1.2Vancomycin HCl + L-Lysine + N-acetyl-D-Alanine + 2M HCl^(#) 0.2 1.0 1.9Vancomycin HCl + L-Lysine + N-acetyl-D-Alanine + 0.4M NaOH^(#) 0.2 1.01.7 Vancomycin HCl + L-Lysine + N-acetyl-D-Alanine + 0.4M NaOH^(#) 0.20.7 1.1 Vancomycin HCl + L-Lysine + N-acetyl-D-Alanine + 0.5M HCl^(#)0.3 0.6 0.9 Vancomycin HCl + L-Lysine + N-acetyl-D-Alanine + 2M/0.4MNaOH^(#) 0.3 0.5 0.9 Vancomycin HCl + L-Lysine HCl +N-acetyl-D-Alanine + 2M/1M/0.4M NaOH^(#) 0.2 0.7 1.3 Vancomycin HCl +L-Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) 0.3 0.5 na na—notanalyzed ^(#)Used as pH adjusting agent (*)only 2 weeks data available(at 30 ± 2° C./75 ± 5% RH)

Example 4—Stabilization Effect of Organic Solvents

Pharmaceutical compositions of Vancomycin hydrochloride containing anorganic solvent (ethanol, PEG 300 or PEG 400) were prepared in varyingconcentrations, and in certain formulations pH was further adjustedusing diluted HCl solution and/or diluted NaOH solution. AfterVancomycin and amino acids were added into the solution in the molarratio specified in Table 4 below, the solution was mixed untilsubstances were dissolved.

TABLE 4 Purity (%) DAMS (%) CDP1 (%) Vancomycin Molar Used 4 weeks 4weeks 4 weeks Composition conc. (%) ratio pH solvent START at 25° C.START at 25° C. START at 25° C. N-acetyl-D-Alanine + 5 2:1 3.06Ultrapure 96.5 94.9 0.6 1.2 0.2 1.1 Vancomycin base + 4M HCl^(#) waterN-acetyl-D-Alanine + 5 2:1 2.99 9.6% EtOH 96.5 94.9 0.6 1.0 0.2 0.9Vancomycin base + in 9.6% in ethanol (V/V) in ultrapure ultrapurewater + 4M HCl^(#) water Vancomycin HCl 10 / 3.05 Ultrapure 96.2 87.50.7 4.3 0.2 5.2 water Vancomycin HCl in 40% PEG 10 / 2.88 40% PEG 96.390.9 0.6 3.4 0.2 1.5 300 (V/V) in ultrapure water 300 + 60% ultrapurewater Vancomycin HCl in 40% PEG 10 / 2.74 40% PEG 96.5 91.3 0.7 3.3 0.11.5 400 (V/V) in ultrapure water 400 + 60% ultrapure water VancomycinHCl + L-Lysine + 5 1:2:2 5.47 Ultrapure 96.4 95.8 0.6 0.6 0.2 0.8N-acetyl-D-Alanine + 0.4M water NaOH^(#) Vancomycin HCl + L-Lysine + 51:2:2 5.06 20% PEG 96.2 96.2 0.6 0.6 0.2 0.4 N-acetyl-D-Alanine in 20%300 + 80% PEG 300 (V/V) in ultrapure ultrapure water water VancomycinHCl + L-Lysine + 5 1:2:2 4.91 20% PEG 96.2 96.1 0.6 0.7 0.3 0.4N-acetyl-D-Alanine in 20% 400 + 80% PEG 400 (V/V) in ultrapure ultrapurewater water Vancomycin HCl + L-Lysine 5 1:2:2 5.46 Ultrapure 96.4 95.80.6 0.6 0.2 0.6 HCl + N-acetyl-D-Alanine + water 2/0.5M NaOH^(#)Vancomycin HCl + L-Lysine 5 1:2:2 5.51 55% PEG 96.3 96.3 0.6 0.5 0.3 0.3HCl + N-acetyl-D-Alanine + 400 + 45% 5/2/0.5M NaOH^(#) in 55% PEGultrapure 400 (V/V) in ultrapure water water Vancomycin HCl + L-Lysine 51:2:2 5.48 10% PEG 96.3 95.8 0.6 0.6 0.3 0.5 HCl + N-acetyl-D-Alanine +400 + 90% 2/0.5M NaOH^(#) in 10% PEG ultrapure 400 (V/V) in ultrapurewater water Vancomycin HCl + L-Lysine 0.5 1:20:20 5.51 0.9% NaCl 96.395.8 0.6 0.6 0.2 0.7 HCl + N-acetyl-D-Alanine + 2/1/0.4M NaOH^(#)Vancomycin HCl + L-Lysine 0.5 1:20:20 5.49 5.5% PEG 96.3 96.0 0.6 0.60.2 0.5 HCl + N-acetyl-D-Alanine + 400 + 94.5 0.1/0.5/1/2M NaOH^(#) in5.5% 0.9% NaCl PEG 400 (V/V) in 0.9% NaCl Vancomycin HCl + L-Lysine 0.51:20:20 5.50 5.5% PEG 96.4 96.0 0.5 0.5 0.3 0.4 HCl +N-acetyl-D-Alanine + 400 + 0.5/2M NaOH^(#) in 5.5% PEG 94.5% 5% 400(V/V) in 5% dextrose dextrose Vancomycin HCl + L-Lysine 0.5 1:20:30 5.490.9% NaCl 96.4 96.0 0.5 0.6 0.3 0.5 HCl + N-acetyl-D-Alanine + 2MNaOH^(#) Vancomycin HCl + L-Lysine 0.5 1:20:30 5.43 5.5% PEG 96.4 96.00.6 0.6 0.2 0.5 HCl + N-acetyl-D-Alanine + 400 + 2/0.5M NaOH^(#) in 5.5%PEG 94.5% 400 (V/V) in 0.9% NaCl 0.9% NaCl ^(#)Used as pH adjustingagent

Example 5

Antibacterial Susceptibility Testing

Testing was performed using broth dilution method according to Clinicaland Laboratory Standards Institute (CLSI) guidelines M100-S23/S24;M07-A9, the disclosure of which is herein incorporated by reference.

The antibiotic activity of eight aqueous pharmaceutical compositions wasdetermined and compared to the activity of the injectable referencefinished product, Vancocin, manufactured by Flynn Pharma Ltd. Antibioticactivity was determined against quality control strains: Staphylococcusaureus ATCC 29213, Enterococcus faecalis ATCC 29212 and Streptococcuspnemoniae ATCC 49619. These solutions were stored at 25 degrees Celsiusfor the time periods indicated, and the results are shown in Table 5below.

A further 13 solutions were stored under the same conditions as thoseshown in Table 5 for the time periods indicated, and were tested usingthe same CLSI protocol against two different Vancomycin solutionstandards and an amoxicillin standard. The results are shown in Table 6below. Table 7 shows referent minimum inhibitory concentration (MIC)ranges for evaluation of Vancomycin solution activity against testedquality control strains according to the CLSI protocol. As shown inTables 5 and 6, all tested solutions of the invention demonstratedantibiotic activity comparable to the control reference solution, andthe MICs measured were all within the CLSI referent MIC ranges,demonstrating that the tested solutions were stable.

TABLE 5 MIC (μg/mL) Test period in Vancomycin StaphylococcusEnterococcus Streptococcus Test article days Composition Molar ratioconc. (%) pH aureus faecalis pnemoniae Vancocin / / / / / 1 2 0.25(reference lyophilized product) 1 85 10% 96% ethanol + D- 2:2:1 10 3.021 4 0.25 Alanine + L-Lysine + Vancomycin HCl + 4M HCl^(#) 2 58N-acetyl-D-Alanine + L- 2:2:1 5 3.05 1 4 0.25 Lysine + Vancomycin HCl +4M HCl^(#) 3 58 N-acetyl-D-Alanine + 2:1 5 3.06 1 4 0.25 Vancomycin + 4MHCl^(#) 4 25 N-acetyl-D-Alanine + L- 2:2:1 5 4.29 0.5 4 0.25 Lysine +Vancomycin HCl 5 10 N-acetyl-D-Alanine + L- 2:2:1 5 4.43 1 2 0.25Lysine + Vancomycin HCl + 1M NaOH 6 10 N-acetyl-D-Alanine + L- 2:2:1 55.45 1 4 0.25 Lysine + Vancomycin HCl + 1M NaOH 7 9 N-acetyl-D-Alanine +L- 2:2:1 5 5.11 1 4 0.125 Lysine + Vancomycin HCl (in 0.9% NaCl) 8 6Vancomycin HCl + L- 1:2:2 5 4.08 1 4 0.125 Lysine + N-acetyl-D-Alanine^(#)Used as pH adjusting agent

TABLE 6 Test Staphylococcus Enterococcus Streptococcus period Vancomycinaureus faecalis pneumoniae Test article in days Composition Molar ratioconc. (%) pH MIC (μg/mL) Amoxicillin USP 1 0.5 0.06 standard CLSI rangeCLSI range CLSI range (0.5-2) (0.5-2) (0.03-0.125) Vancomycin USP 1 20.125 standard CLSI range CLSI range CLSI range (0.5-2) (1-4)(0.125-0.5) Vancocin — — — 5 — 1 2 0.125 (reference lyophilized product) 1 195 Vancomycin HCl + L- 1:2:2 5 5.51 1 4 0.25 Lysine HCl +N-acetyl-D- Alanine + 5/2/0.5M NaOH^(#) in 55% PEG 400 (V/V) inultrapure water  2 154 Vancomycin HCl + L- 1:2:2 5 5.48 1 4 0.25 LysineHCl + N-acetyl-D- Alanine + 2/0.5M NaOH^(#) in 10% PEG 400 (V/V) inultrapure water  3 150 Vancomycin HCl + L- 1:20:30 0.5 5.43 1 2 0.25Lysine HCl + N-acetyl-D- Alanine + 2/0.5M NaOH^(#) in 5.5% PEG 400 (V/V)in 0.9% NaCl  4 128 Vancomycin HCl + L- 1:2:2 5 5.04 1 2 0.125 LysineHCl + N-acetyl-D- Alanine + 4/2M NaOH^(#)  5 126 Vancomycin HCl + L-1:2:2 5 5.05 1 2 0.25 Lysine HCl + N-acetyl-D- Alanine + 4M NaOH^(#)  679 Vancomycin HCl + L- 1:2:2 5 5.30 1 2 0.25 Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 18% PEG 400 (V/V) in ultrapure water  7 79Vancomycin HCl + L- 1:2:2 5 5.31 1 2 0.25 Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 30% PEG 400 (V/V) in ultrapure water  8 78Vancomycin HCl + L- 1:2:2 5 5.14 1 2 0.125 Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 40% PEG 400 (V/V) in ultrapure water  9 70Vancomycin HCl + L- 1:20:30 0.5 5.03 1 2 0.125 Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 0.9% NaCl 10 44 Vancomycin HCl + L- 1:20:30 0.55.05 1 4 0.25 Lysine HCl + N-acetyl-D- Alanine + 2M NaOH^(#) in 1.8% PEG400 (V/V) in 0.9% NaCl 11 160 Vancomycin HCl + L- 1:20:30 0.5 5.49 1 20.25 Lysine HCl + N-acetyl-D- Alanine + 2M NaOH^(#) in 0.9% NaCl 12 155Vancomycin HCl + L- 1:2:2 5 5.43 1 2 0.25 Lysine HCl + N-acetyl-D-Alanine + 4/2M NaOH^(#) 13 120 Vancomycin HCl + L- 1:2:2 5 5.03 1 2 0.25Lysine HCl + N-acetyl-D- Alanine + 4/2M NaOH^(#) ^(#)Used as pHadjusting agent

TABLE 7 Referent MIC ranges (μg/mL) QC strains Vancomycin Staphylococcusaureus ATCC 29213 0.5-2   Enterococcus faecalis ATCC 29212 1-4Streptococcus pnemoniae ATCC 49619 0.125-0.5 

Example 6—Lack of Stabilization of Solutions Containing Vancomycin andPeptides

Solutions containing N-acetylated di- and tri-peptides in place ofN-acetyl-amino acids were made. It was found that the pH of theformulations made with the N-acetylated di- and tri-peptides could notbe raised much above about pH 3, since the solutions started to appearhazy already at that pH value. Also, a solution containingN-acetyl-D-Alanine-D-Alanine and L-Lysine could not be made withVancomycin concentrations above about 0.2%, as it was observed that thesolutions became hazy as the Vancomycin concentrations approached about0.5%. Moreover, the low pH values necessary to maintain the solubilityof Vancomycin in solutions containing N-acetylated di- and tri-peptidesin place of N-acetyl-amino acids would cause rapid degradation ofVancomycin. Thus, these solutions were not considered stable or suitablefor use as a pharmaceutical solution in a clinical setting. The resultsof this experiment are presented in Table 8 below.

The solutions were made by dissolving eitherN-acetyl-D-Alanine-D-Alanine or Di-acetyl-L-Lysine-D-Alanine-D-Alaninein water or 0.9% sodium chloride. In one formulation, L-Lysine was thenadded. Vancomycin was then added, and in some formulations the pH wasadjusted using diluted hydrochloric acid to around pH 3. WhereVancomycin HCl salt was used, no pH adjustment was done. For theformulation containing L-Lysine, the formulation was intended to have0.5% w/V Vancomycin concentration, but after adjusting the pH to around2.5 the solution was still hazy. This solution was then further dilutedin order to make it less hazy, and concentration of 0.2% w/V Vancomycinwas obtained. Concentration of Vancomycin B, DAMS and CDP1 were measuredby HPLC as described above in the Examples: General Techniques.Solutions were stored in glass vials and kept at 25 degrees Celsius forfour weeks, except for the solution containingDi-acetyl-L-Lysine-D-Alanine-D-Alanine+Vancomycin HCl+4M HCl, for whichonly two-weeks stability data was available.

TABLE 8 Vancomycin Composition conc. (%) Molar ratio pH Vancomycin HCl 5/ 3.13 Vancomycin HCl 10 / 3.05 N-acetyl-D-Alanine-D-Alanine + 0.5 1:12.95 Vancomycin HCl + 4M HCl^(#) N-acetyl-D-Alanine-D-Alanine + 0.5 1:12.67 Vancomycin HCl N-acetyl-D-Alanine-D-Alanine + L- 0.2 1:1:1 2.50Lysine + Vancomycin HCl + 4M HCl^(#) in 0.9% NaCl Di-acetyl-L-Lysine-D-0.5 1:1 2.95 Alanine-D-Alanine + Vancomycin HCl + 4M HCl# in 0.9% NaCl^(#)Used as pH adjusting agent

Example 7—Stable Vancomycin Solutions

Aqueous pharmaceutical compositions of Vancomycin were prepared andtested as described in Examples 1-3 above, and the results are given inTable 9. As shown in Table 9, the solutions of the invention were stablefor 3 and 6 months under the conditions tested. These results, inparticular the data for Vancomycin Purity, DAMS and CDP1 after 3 and 6months at 25 degrees Celsius, can be extrapolated to indicate that thesolutions are stable or stabilized for up to about 21 to >24 months.

TABLE 9 Calculated shelf life according to Purity (%) DAMS (%) CDP1 (%)Vancomycin Vanco. Molar 6 months at 6 months at 6 months at purity/Composition conc. (%) ratio pH START 25° C. START 25° C. START 25° C.months Vancomycin HCl + 5 1:2:2 5.03 96.2 93.9 0.6 0.5 0.3 2.7 22L-Lysine HCl + N-acetyl-D-Alanine + 4/2M NaOH^(#) Vancomycin HCl + 51:2:2 5.51 96.3 95.6 0.6 0.4 0.3 0.5 >24 L-Lysine HCl + N-acetyl-D-Alanine + 5/2/0.5M NaOH^(#) in 55% PEG 400 (V/V) in ultrapurewater Calculated shelf life according to Purity (%) DAMS (%) CDP1 (%)Vancomycin Vanco. Molar 3 months at 3 months at 3 months at purity/Composition conc. (%) ratio pH START 25° C. START 25° C. START 25° C.months Vancomycin HCl + 5 1:2:2 5.30 96.2 95.4 0.6 0.4 0.3 0.9 >24L-Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 18% PEG 400 (V/V) inultrapure water Vancomycin HCl + 0.5 1:20:30 5.49 96.4 95.2 0.5 0.6 0.31.2 21 L-Lysine HCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 0.9% NaClVancomycin HCl + 0.5 1:20:30 5.06 96.2 95.0 0.6 0.5 0.3 1.2 21 L-LysineHCl + N-acetyl-D-Alanine + 2M NaOH^(#) in 1.8% PEG 400 (V/V) in 0.9%NaCl ^(#)Used as pH adjusting agent

Example 8—Stable Glycopeptide Antibiotic Solutions

Aqueous Pharmaceutical Compositions Of Teicoplanin, Telavancin,Dalbavancin And Oritavancin Are Prepared And Tested As Described InExamples 1-3 And 7 Above. It Is Expected That The Solutions Are StableFor 3 And 6 Months At 25 Degrees Celsius, And That This Can BeExtrapolated To Indicate That The Solutions Are Stable Or Stabilized ForUp To About 24 Months.

The invention claimed is:
 1. A stable aqueous pharmaceutical compositioncomprising about 0.5-5% w/V vancomycin, and N-acetyl-D-Alanine; whereinthe pharmaceutical composition is stable for at least about 10 weeks atabout 25 degrees Celsius, wherein the amount of vancomycin remaining inthe pharmaceutical composition at about 10 weeks is at least 90% andfurther wherein (i) the composition has a pH of 4.5-5.5 and/or (ii) thecomposition comprises an amino acid.
 2. The stable aqueouspharmaceutical composition of claim 1, wherein the composition has a pHof 4.5-5.5.
 3. The stable aqueous pharmaceutical composition of claim 1,wherein the molar ratio of N-acetyl-D-Alanine to vancomycin is about1:1-30:1.
 4. The stable aqueous pharmaceutical composition of claim 3,wherein the amount of the vancomycin remaining is determined by liquidchromatography in accordance with USP 36-NF
 31. 5. The stable aqueouspharmaceutical composition of claim 1, wherein the composition comprisesan amino acid.
 6. The stable aqueous pharmaceutical composition of claim5, wherein the amino acid is chosen from the group consisting ofD-Alanine, D-Serine, D-Leucine, D-Valine, L-Lysine, D-Lysine,L-Ornithine, D-Ornithine and L-Arginine.
 7. The stable aqueouspharmaceutical composition of claim 5, wherein the amino acid isL-Lysine.
 8. The stable aqueous pharmaceutical composition of claim 5,wherein the composition has a pH of 4.5-5.5.
 9. The stable aqueouspharmaceutical composition of claim 5, wherein the molar ratio ofN-acetyl-D-Alanine to vancomycin is about 1:1-30:1.
 10. The stableaqueous pharmaceutical composition of claim 5, wherein the molar ratioof the amino acid to vancomycin is about 1:1-20:1.
 11. The stableaqueous pharmaceutical composition of claim 9, wherein the amount of thevancomycin remaining is determined by liquid chromatography inaccordance with USP 36-NF
 31. 12. A stable aqueous pharmaceuticalcomposition comprising about 0.5-5% w/V vancomycin; N-acetyl-D-Alanine;and L-lysine, wherein the pharmaceutical composition is stable for: (a)at least about 3 months at about 25 degrees Celsius, wherein the amountof vancomycin remaining in the pharmaceutical composition at 3 months isat least 85%; or (b) at least about 12 months at about 25 degreesCelsius, wherein the amount of vancomycin remaining in thepharmaceutical composition at about 12 months is at least 85%.
 13. Thestable aqueous pharmaceutical composition of claim 12, wherein thecomposition has a pH of about 4.5-5.5.
 14. The stable aqueouspharmaceutical composition of claim 12, wherein the compositioncomprises about 0.5% w/V of vancomycin and a pharmaceutically acceptableorganic solvent comprising about 1.8% V/V of polyethylene glycol. 15.The stable aqueous pharmaceutical composition of claim 12, wherein themolar ratio of N-acetyl-D-Alanine to vancomycin is about 1:1-30:1. 16.The stable aqueous pharmaceutical composition of claim 12, wherein themolar ratio of the L-Lysine to vancomycin is about 1:1-20:1.
 17. Thestable aqueous pharmaceutical composition of claim 12, wherein theamount of the vancomycin remaining is determined by liquidchromatography in accordance with USP 36-NF
 31. 18. A stable aqueouspharmaceutical composition comprising about 0.5-5% w/V vancomycin;N-acetyl-D-Alanine; and L-lysine, wherein the pharmaceutical compositionis stable: (a) at least about 3 months at about 25 degrees Celsius,wherein the amount of vancomycin remaining in the pharmaceuticalcomposition at 3 months is at least 90%; or (b) at least about 12 monthsat about 25 degrees Celsius, wherein the amount of vancomycin remainingin the pharmaceutical composition at about 12 months is at least 85%.19. The stable aqueous pharmaceutical composition of claim 18, whereinat about 12 months the amount of the vancomycin remaining is at least90%.
 20. The stable aqueous pharmaceutical composition of claim 18,wherein the composition has a pH of about 4.5-5.5.
 21. The stableaqueous pharmaceutical composition of claim 18, wherein the compositioncomprises about 0.5% w/V of vancomycin and a pharmaceutically acceptableorganic solvent comprising about 1.8% V/V of polyethylene glycol. 22.The stable aqueous pharmaceutical composition of claim 18, wherein themolar ratio of N-acetyl-D-Alanine to vancomycin is about 1:1-30:1. 23.The stable aqueous pharmaceutical composition of claim 18, wherein themolar ratio of the L-Lysine to vancomycin is about 1:1-20:1.
 24. Thestable aqueous pharmaceutical composition of claim 22, wherein theamount of the vancomycin remaining is determined by liquidchromatography in accordance with USP 36-NF 31.